Abnormalities of Teeth Flashcards

1
Q

3 causes of focal enamel hypoplasia

A

Idiopathic

Caries

Trauma

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2
Q

Describe Turner’s tooth

A

When caries or trauma in a deciduous tooth results in an infection of the developing tooth bud, causing enamel hypoplasia (Turner’s hypoplasia; usually affecting the permanent bicuspids)

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3
Q

Which teeth would be affected by generalized enamel hypoplasia manifesting in the 1st year?

A

Incisors

Cuspids

First molars

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4
Q

Which teeth would be affected by generalized enamel hypoplasia manifesting at age three?

A

Premolars

Second and third molars

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5
Q

Most common disturbance in enamel

A

Fluorosis

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6
Q

2 enamel disturbances due to Syphilis

A

Hutchinson’s incisors

Mulberry Molars

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7
Q

Period of development for the crowns of deciduous teeth

A

Week 14 in utero to 12 months old

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8
Q

Period of development of the crowns of permanent teeth

A

6 months to 15 years old

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9
Q

Define fluorosis

A

Excessive fluoride during tooth development

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10
Q

Period of development during which fluorosis may occur in order to affect the enamel of permanent teeth

A

After birth and before 6 years

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11
Q

Effect of fluorosis

A

Enamel hypoplasia and hypocalcification

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12
Q

3 physical appearances of fluorosis

A
  • White enamel spots
  • Mottle brown areas and white spots
  • Pitted irregular discolored enamel
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13
Q

Define molar-incisor-hypomineralization

A

Hypomineralization of one to four permanent first molars, incisors are affected frequently. May fracture or become carious

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14
Q

Describe the appearance of molar-incisor hypomineralization

A

White/yellow or brown enamel

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15
Q

Bacteria causing syphilis

A

Treponema pallidum (a spirochete)

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16
Q

3 types of post-developmental loss of tooth structure

A
  • Attrition
  • Erosion
  • Abfraction
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17
Q

Define attrition

A

Loss of tooth structure due to the mechanical action of mastication

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18
Q

2 pathologic causes of attrition

A

Bruxism

More abrasive diets

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19
Q

Effect of attrition on dentin

A

Formation of tertiary or reparative dentin

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20
Q

Define abrasion

A

Abnormal loss of tooth structure due to friction

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21
Q

5 potential causes of abrasion

A
  • Toothbrushes
  • Toothpastes
  • Toothpicks
  • Dental floss
  • Pipe smokrs who chew on stem of pipe
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22
Q

Define erosion

A

Loss of tooth structure due to non-bacterial chemical causes

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23
Q

2 causes of erosion on labial surfaces of teeth

A

Citrus fruits

Carbonated beverages

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24
Q

3 causes of erosion on lingual surfaces of teeth

A

Bulimia

Chronic vomiting

Pregnancy (morning sickness)

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25
Q

Occupational cause of erosion

A

Welders (acidic gases inhaled through the mouth)

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26
Q

Define abfraction

A

Loss of tooth structure from occlusal stresses (cracked enamel is then lost through erosion or abrasion)

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27
Q

Define internal resorption as a form of tooth loss

A

Form of tooth loss that begins in the pulp (idiopathic)

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28
Q

Describe the appearance of a tooth having undergone internal resorption

A

Tooth may start to develop a pink color

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29
Q

Treatment of tooth affected by internal resorption

A

Obtain radiograph –> root canal in time may prevent tooth from being lost

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30
Q

Define external resorption as a form of tooth loss

A

Loss of tooth structure that begins on the surface

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31
Q

6 potential causes of external resorption

A
  • Idiopathic if cervical
  • Mid-root = trauma
  • Apex = inflammatory
  • Impacted teeth may undergo resorption
  • Orthodontic movements
  • Transplanted or re-implanted teeth
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32
Q

Define ankylosis

A

Fusion of cementum or dentin to bone after loss of periodontal membrane

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33
Q

Tooth most commonly affected by ankylosis

A

Primary second molar (may lead to submerged deciduous molar)

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34
Q

Potential effect of tetracylcine on teeth

A

Yellowish-brown intrinsic discoloration of teeth (incorporated into bone and enamel); fluorescent under U-V light

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35
Q

When should tetracylcine not be used in order to avoid tooth discoloration

A

Do not use in pregnant women in second and third trimester and until age seven

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36
Q

Define congenital porphyria

A

Excessive porphyrins in blood

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37
Q

2 effects of congenital porphyria

A

Pinkish brown teeth that fluoresce bright scarlet with U-V light

Skin = photosensitivity

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38
Q

2 effects of biliary atresia

A

Elevated bilirubin

Dark green teeth

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39
Q

Define erythroblastosis fetalis

A

Hemolytic anemia due to Rh-negative mother carrying an Rh-positive fetus causing maternal antibodies to form

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40
Q

Effects of erythroblastosis fetalis on teeth

A

Bluish-green to yellowish grey teeth (deciduous only)

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41
Q

2 types of disturbances of tooth size

A

Microdontia (true/relative)

Macrodontia (true/relative)

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42
Q

Cause of true generalized microdontia

A

Pituitary dwarfism

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43
Q

Cause of relative generalized microdontia

A

Big jaws

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44
Q

First and seconf most common examples of localized microdontia

A

Peg lateral

Maxillary third molar

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45
Q

Example of a supernumary microdont

A

4th molar

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46
Q

Cause of true generalized macrodontia

A

Pituitary gigantism

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47
Q

Tooth most commonly affected by localized macrodontia

A

Mandibular 3rd molars

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48
Q

2 conditions that may result in macrodontia

A

Hemifacial hypertrophy

Oculo-facial-cardio-dental syndrome

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49
Q

2 disturbances of tooth number

A

Total or partial anodontia

Supernumary teeth

50
Q

Define total anodontia

A

No deciduous NOR permanent teeth

51
Q

3 most commonly congenitally missing permanent teeth

A

Third molars

Maxillary lateral incisors

Second premolars

52
Q

Most commonly congenitally missing deciduous tooth

A

Maxillary lateral (although uncommon)

53
Q

Potential cause of pseudoanodontia

A

Gingival hyperplasia (fibromatosis) causing the gums to completely cover the teeth

54
Q

When does ankylosis usually occur

A

In deciduous teeth if permanent tooth is missing

55
Q

Define ectodermal dysplasia

A

Inherited syndrome where two or more ectodermally derived anatomic structures are missing

56
Q

3 potential manifestations of ectodermal dysplasia

A
  • Hypoplasia or aplasia of tissues such as skin, hair, nails, teeth, salivary or sweat glands
  • Missing teeth
  • Abnormal shape of teeth
57
Q

Inheritance of hypohidrotic ectodermal dysplasia

A

X-linked

58
Q

6 manifestations of hypohidrotic ectodermal dysplasia

A
  • Partial anodontia
  • Conical teeth
  • Fine sparse hair
  • Lack of sweat glands
  • Nails - dystrophic brittle
  • Dry mouth (lack of salivary glands)
59
Q

In which are are supernumary teeth more often found?

A

90% in maxilla (10% in mandible)

60
Q

Most common supernumary teeth

A

Mesiodens (supernumary upper anterior tooth)

61
Q

3 supernumary teeth found in the mandible

A

Premolars

4th molars

Incisors

62
Q

2 examples of syndromes to rule out if multiple supernumary teeth are present

A
  • Cleidocranial dysplasia
  • Gardner’s Syndrome
63
Q

5 characteristics of cleidocranial dysplasia

A
  • Lack of clavicles (long neck appearance)
  • Frontal, parietal, and occipital bossing
  • Hypertelorism (widely spaced eyes)
  • Unerupted supernumary teeth
  • Failure of eruption of permanent teeth
64
Q

Inheritance pattern of Gardner’s Syndrome

A

Autosomal dominant

65
Q

4 characteristics of Gardner’s Syndrome

A
  • Multiple osteomas
  • Colonic polyps (premalignant adenomas) since associated with FAP
  • Impacted permanent and supernumary teeth
  • Epidermal and pilar cysts and skin fibromas
66
Q

4 disturbances in eruption

A
  • Premature eruption
  • Delayed eruption
  • Impacted teeth
  • Eruption sequestrum
67
Q

Define natal teeth

A

Premature eruption; deciduous teeth present at birth. Avoid extraction

68
Q

Usual natal teeth

A

Mandibular central incisors

69
Q

Define neonatal teeth

A

Premature eruption; deciduous teeth which erupt within first 30 days

70
Q

Condition to rule out if entire premature eruption occurs

A

Hyperthyroidism

71
Q

3 conditions that may cause delayed eruption

A
  • Rickets
  • Cleidocranial dysplasia
  • Cretinism (stunted physical and mental growth due to congenital hypothyroidism)
72
Q

Local factor that may cause delayed eruption

A

Gingival fibromatosis (physically blocks tooth eruption)

73
Q

Define impaction

A

Obstruction preventing normal eruption

74
Q

List the teeth most frequently impacted in order of frequency (most to least)

A
  1. Mandibular/maxillary third molars
  2. Maxillary cuspids
  3. Mandibular second premolars
  4. Supernumary teeth
75
Q

Usual causes of impaction

A

Crowding/ other teeth, but may be due to cysts or tumors

76
Q

4 classifications of 3rd molar impaction

A
  • Mesioangular
  • Distoangular
  • Horizontal
  • Vertical

(Can help determine whether you should extract yourself or refer to surgeon)

77
Q

5 indications for 3rd molar extraction when impacted

A
  • Root resorption
  • Infection
  • Pain
  • Cyst
  • External resorption
78
Q

Define eruption sequestrum

A

Small fragment of bone in soft tissues over an erupting mandibular molar tooth

79
Q

Define dilaceration

A

Extraordinary curving of roots resulting in difficult extractions and endodontics

80
Q

Define taurodontism

A

Bull teeth; elongated crowns and apically displaced furcations

81
Q

4 syndromes/conditions associated with taurodontism

A
  • Amelogenesis imperfecto
  • Down syndrome
  • Klinefelter’s syndrome
  • Tricho-dento-osseous syndrome (Kinky hair)
82
Q

Race most affected by taurodontism

A

Inuit

83
Q

Define dens invaginatus

A

Tooth within a tooth (dens in dente); exaggeration of the lingual pit that may be superficial or deep. Usually bilateral

84
Q

Most commonly affected tooth by dens invaginatus

A

Maxillary lateral incisor

85
Q

Usual management of dens invaginatus

A

Placement of a prophylactic composite filling

86
Q

Define dens evaginatus

A

Supernumary cusp, often bilateral; anomalous cusp/tubercle on occlusal surface

87
Q

Usual teeth affected by dens evaginatus

A

Premolars

88
Q

Races most often affected by dens evaginatus

A

Asians

Inuit

Native Americans

89
Q

Potential consequence of abrasion on dens evaginatus and how to deal with it

A

Abrasion may lead to pulp exposure –> identify problem early and correct with occlusal adjustment of opposing tooth

90
Q

Define talon cusp

A

Supernumary cusps; abnormal lingual cusps

91
Q

Syndrome in which talon cusps are a feature

A

Rubenstein-Tabes syndrome (unlike dens evaginatus, which is not a feature)

92
Q

3 teeth most frequently affected by supernumary roots

A

Mandibular canines

Premolars

Third molars

93
Q

Define gemination

A

Attempt to form two teeth from one enamel organ; partial division of a single tooth germ/ two crowns that share one root canal

Usually anteriors

94
Q

Define fusion

A

Extra wide crown; joining of two developing tooth bods involving either entire tooth or only roots. Root canals separate or shared

95
Q

Difference in tooth number between fusion and gemination

A

Gemination = normal number of teeth

Fusion = missing one tooth

96
Q

Define concrescence

A

Two completely formed teeth are joined by cementum

97
Q

Teeth usually affected by concrescence

A

Maxillary 2nd and 3rd molars

98
Q

Define hypercementosis

A

Roung bulbous roots due to excess production of cementum. May be acquired (related to inflammation), idiopathic or associated with other diseases

99
Q

2 diseases associated with hypercementosis

A

Paget’s disease of bone

Hyperpituitarism

100
Q

Define enamel pearls

A

Cervical enamel projection; droplets of ectopic enamel found on roots of teeth

101
Q

Teeth most commonly affected by enamel pearls

A

Maxillary molars

102
Q

Why must one be cautious when removing enamel pearls?

A

May have a pulp horn

103
Q

Define amelogenesis imperfecta

A

Inherited defect in enamel in absence of a systemic disorder or syndrome. Various patterns of inheritance

NOTE: At least 14 subtypes phenotypic classification Witkop. Better classificaiton would be molecular based - related gene defects

104
Q

3 stages of enamel formation

A
  1. Elaboration of organic matrix
  2. Mineralization of matrix
  3. Maturation of enamel
105
Q

Define hypoplastic amelogenesis imperfecta

A

Inadequate deposition of enamel matrix. Generalized (localized) small pits and smooth patterns

106
Q

Define hypocalcified amelogenesis imperfecta

A

Normal enamel thickness but soft and friable. Yellow-brown on eruption

107
Q

Define hypomaturation amelogenesis imperfecta

A

Normal hardness of enamel but chips away easily. Pigmented pattern, X-linked and snow capped

108
Q

What form of amelogenesis imperfect has taurodontism

A

Hypomaturation/hypoplastic form

109
Q

Inheritance pattern of dentinogenesis imperfecta

A

Autosomal dominant

110
Q

Describe dentinogenesis imperfecta (5 points)

A
  • Translucent teeth
  • Enamel fractures easily
  • Constriction at CEJ (bell-shaped crown)
  • Short blunt roots
  • Opacification of pulps or may have enlarged pulp chambers
111
Q

Inheritance pattern of osteogenesis imperfecta with opalescent teeth

A

Autosomal dominant or recessive

112
Q

2 other characteristics of osteogenesis imperfecta with opalescent teeth

A

Blue sclera

Multiple bone fractures with normal activities

113
Q

Inheritance pattern of dentin dysplasia

A

Autosomal dominant

114
Q

2 types of dentin dysplasia

A

Type I radicular

Type II coronal

115
Q

DIfference between type I and type II dentin dysplasia

A

Type I = color of both dentitions normal

Type II = color of primary teeth opalescent

116
Q

3 characteristics of type I dentin dysplasia

A

Also known as Rootless Teeth:

  • Periapical lesions common
  • Roots very short
  • Pulps obliterated
117
Q

Describe the pulp in Type II dentin dysplasia

A

Thistle tube pulps

118
Q

Define regional odontodysplasia

A

Teeth in a region have thin enamel and enlarged pulp chambers. Known as “Ghost Teeth”.

119
Q

2 possible causes of regional odontodysplasia

A

Mostly idiopathic but may be associated with a hemangioma or vascular malformation

120
Q

Usual consequene of regional odontodysplasia

A

Extractino of teeth usually necessary